The craniomandibular index: Validity

James R Fricton, Eric L. Schiffman

Research output: Contribution to journalArticlepeer-review

134 Scopus citations


The CMI appears to be valid for use in clinical studies, but users must be aware of its numerous potential errors and its associated strict methodologic guidelines to ensure accuracy and reproducibility of results. The subjective nature of some items demands that the same rater who is unaware of the management status of the patient perform both evaluations. If multiple raters are used, it is recommended that the raters discuss all items, and compare scoring of demonstration subjects before the study and use a pressure algometer for muscle palpation.

Original languageEnglish (US)
Pages (from-to)222-228
Number of pages7
JournalThe Journal of Prosthetic Dentistry
Issue number2
StatePublished - Aug 1987

Bibliographical note

Funding Information:
Funding for this study was provided by the University of Minnesota Graduate School. *Associate Professor, TMJ and Craniofacial Pain Clinic, Department of Oral and Maxillofacial Surgery. **Instructor TM J and Craniofacial Pain Clinic, Department of Oral and Maxillofacial Surgery.

Funding Information:
This study supports construct and criterion validity and potential usefulnesso f the Ch?I in clinical outcome studies. In each study the scores of the CM1 acted in accordancew ith expectationst hat the CM1 measurest he severityo f craniomandibular problems.F irst, pretesting and 6-month posttestingo f 24 patients with jaw pain and dysfunctionw ho participatedi n a teamm anagement program demonstrateds ignificant improvementi n the CM1 and the symptom severity index. Second, the pretests coreso f the CM1 were positively correlatedw ith the symptom severity index. Third, the scores of the CM1 for patients with progressivelym ore severeT MJ internal derangementsw ere progressively higher and were different than normal controls. CM1 scores for patients with a primary diagnosis of MPD were also different than normal controls. Criterion validity was supported by the positive correlation betweent he CM1 and Helkimo’s dysfunction index. Although the entire CM1 is a good measureo f global severity of a craniomandibular problem, the use of subscales,D I and PI, may be more useful with specific diagnoses. Patients with MPD had higher PI scores, whereas patients with progressivelym ore severeT MJ internal derangementsh ad increasing DI scores.T MJ noise appearedt o increasef rom early to middle stageb ut decreasedin late stage and acute locks, suggestingt hat the disk fails to reduce, which results in less noise. Tenderness of the TMJ increases with progressively more severe internal derangements.S ymptom severity had a higher correlation with the PI than with the DI. This suggests that pain may stem more often from muscle pain than from structural joint pathology and jaw dysfunction. In all indices, normal controls had the lowest scores,s uggestingt hat subjectsw ithout symptoms have little objectivet endernesso r dysfunction.

Copyright 2014 Elsevier B.V., All rights reserved.


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